In India, the second most common cancer among women is that of the cervix out of which approximately 80% are diagnosed at advanced stages, resulting in 79,906 deaths annually (GLOBOCAN 2022). The standard treatment for locally advanced cervical cancer (LACC) (stage IB3–IVA) is concurrent chemo radiation therapy (CRT) involving pelvic external-beam radiotherapy (EBRT), with concurrent weekly cisplatin-based chemotherapy followed by intracavitary brachytherapy (ICBT). Several patient and tumor characteristics have been identified as prognostic factors in the context of radiotherapy (RT) alone or concurrent chemoradiotherapy (CCRT). The detrimental effects of RT prolongation are well-established, with total RT time beyond 7–9 weeks leading to increased pelvic failures (PF), decreased cause-specific survival, and lower overall survival (OS). Early treatment outcomes, such as tumor response rates assessed shortly after the completion of therapy, are critical indicators of long-term prognosis.
This study enrolled 149 patients with histologically confirmed carcinoma cervix, who were treated with definitive CCRT between January 2023 and December 2023. Patients with LACC were treated with concurrent chemoradiation, which included pelvic EBRT with either 3DCRT or IMRT, delivering a dose of 45–50 Gy with Concurrent chemotherapy consisting of weekly cisplatin (40 mg/m²) or Carboplatin (AUC 2) followed by high-dose-rate (HDR) brachytherapy of 7 Gy per fraction in 3–4 fractions.
Treatment response was assessed at 3–6 months’ post-treatment through a combination of clinical examination and imaging (CT scan or MRI of the abdomen and pelvis).
149 patients completed the planned treatment during the study period.
Median OTT was 54 days (45-170 days) with 63.75% of patients completing the treatment within 56 days.
With a median follow-up of 8 months (range, 6–12), on univariate analysis, prolonged OTT (beyond 56 days) was found to be statistically significant with association of incomplete response at 6 months’ post treatment.